Provider Demographics
NPI:1386355147
Name:BLOCHER, JENNIFER LAUREN (MS)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LAUREN
Last Name:BLOCHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:BLOCHER
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3100 SE 168TH AVE APT 231
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-2121
Mailing Address - Country:US
Mailing Address - Phone:585-409-7671
Mailing Address - Fax:
Practice Address - Street 1:1601 E FOURTH PLAIN BLVD BLDG 17
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3717
Practice Address - Country:US
Practice Address - Phone:585-409-7671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral